Originally published July 21, 2014 in The Atlantic.
Medical professionals say the device could be helpful, but patient privacy is still a concern.
Last July, Stephanie Shine waited an agonizing 18 hours before she could see and touch her baby for the first time. He was delivered three and a half months early, weighing one pound and two ounces, and kept in the newborn intensive-care unit (NICU) for 101 days.
Later that summer, when Shine donned Google Glass, she turned on video streaming to show her baby to relatives in other cities. She started to think how incredible the device would have been during her time of separation from him, as she recovered from the delivery. In those initial 18 hours, she could have at least seen her baby as he was held, fed, and nursed to a healthy weight.
As a practicing nurse at Brigham and Women’s Hospital in Boston, Shine is familiar with the mental and emotional stress of women separated from their babies for hours or sometimes days during the post-delivery process. Now, she wants to bring Google Glass to other mothers in this predicament.
Shine is one of many healthcare providers exploring how wearing Glass can improve quality, communication, and education in hospitals. There has been a rush of enthusiasm for the device’s potential applications in healthcare, with more than 240 people attending an event on the subject in Cambridge, Massachusetts in April. But just as it is in the consumer world, privacy is a big hurdle to Glass’s acceptance in the hospital. Medical professionals testing Glass are getting cautious support from hospital administration, but they say the technology of the device needs to catch up before it can reach its desired potential.
Glass has an array of features responsive to voice commands and head movements, useful if your hands are occupied with, say, surgery. But this very sophistication—which makes it easy to record video or take a picture without someone’s knowledge—has led to growing concern over privacy issues. Some of the curious double-takes the contraption received in its earlier days have turned to paranoia or ridicule, and certain venues have even banned the device.
Doctors experimenting with Glass are sensitive to possible violations of the Health Insurance Portability and Accountability Act (HIPAA), the privacy protocol for medicine. “It’s Google, which wants everything publicly available, and healthcare, which wants nothing publicly available,” said Alexandra Pelletier, manager of the FastTrack Innovation in Technology Program at Boston Children’s Hospital.
Karandeep Singh, a nephrologist at Brigham and Women’s Hospital, is waiting for Institutional Review Board (IRB) approval to research the device in an actual physician-patient setting. In the meantime, he has been engineering apps for the device, brainstorming use cases, and pinpointing holes in its system. Singh believes Glass can successfully improve clinical efficiency and physician-patient interaction if introduced in the right way. “In a medical setting, it will be perceived differently than in a public setting,” he said. “When you’re with a patient, that’s a different social contract. And if you’re viewing private patient information, what better way to display it to you than in a way that only you can see it?”
One of the functionalities Singh has engineered is for Glass to connect to patients’ electronic health records. Though designed to improve efficiency, clicking and scrolling on a computer leads a physician to spend a significant amount of time turned away from a patient. And some physicians find it hard to synthesize disparate pieces of data as they click through. “The big mistake many people make is that they assume that the Glass is replacing static desktop displays,” said Paul Lukowicz, a professor in computer science at the Technical University of Kaiserslautern in Germany who consults for the company Wearable Technologies. He sees great value in “precise cross referencing” that goes beyond the normal desktop interface.
With Glass, a doctor could see your last blood pressure reading without ever turning away from you, along with a data visualization of its fluctuations. Voice-to-text processing could mean the end of scribbling down incomplete notes.
In Singh’s application, which I was able to test with a dummy electronic health record, I could mimic doing all these things. “It took me three weeks to get a functional electronic health record app from programming it at home,” Singh said as he handed me his frames.
After I said, “Okay Glass” to get to the home screen of the device, I saw an array of options. “Show me patient vitals,” I said. The heart rate, breathing rate, and blood pressure readings arrived on screen: crude text, but instantaneous. I was still looking straight at Singh, but I could tilt my head slightly down to scroll down and see more details. If I wanted to, I could wink my right eye and take a picture.
But there are certain things the device can’t do, at least as it comes out of the box. Singh found that he couldn’t connect to Wi-Fi Protected Access II, a type of secure network connection many hospitals use. Key features like photo uploading and voice-to-text processing automatically go through Google cloud servers, since Glass has a limited usable memory of 12 GB. You also can’t disable the camera so that it doesn’t accidentally go off. Singh wants a cap to place over the device’s outer surface, both temporarily disabling the camera and indicating visually to an observer that no recording is occurring. Then doctors could remove the cap only when they truly need the camera—to scan a QR code by a patient’s bed, or track wound healing, for instance.
Google Glass spokesperson Chris Dale said that the company is “very focused on making Glass a consumer device.” Dale said that Google is currently not developing industry-specific software, and instead encouraging developers to work with existing hardware to address niche issues like hospital privacy. There is a growing body of startups rising to the occasion. The startupAugmedix sells software that allows doctors to use Glass to input and retrieve patient data securely to and from the electronic health record; it recently announced a deal with Dignity Health, a company that manages hospitals in 17 states. Another big player isPristine, a company that markets itself as “the only HIPAA compliant telehealth and checklist solution for Glass.” Pristine currently offers two products for Glass: Eyesight, a video-based communication platform for telemedicine; and Checklists, a voice-controlled checklist app. To make these HIPAA compliant, Pristine must remove all Google services from the device, essentially wiping the software connection to Google. The catch is that if you wipe Glass like this, you’ll miss system updates that Google would normally automatically push to the device.
Read the rest of the article here in The Atlantic.